Yin H, Ma Y, Yang X, Zhao H, Han M J
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Jun 10;41(6):850-855. doi: 10.3760/cma.j.cn112338-20191129-00844.
To understand the survival status and related influencing factors of HIV-infected children aged ≤14 years old, in China. HIV-infected children were selected from the China's HIV/AIDS Comprehensive Response Information Management System (CRIMS). A retrospective cohort study was conducted to investigate the situation of survival on infected children. Cox proportional hazard regression model was used to screen the factors affecting the survival time. This study involved 8 029 cases of infected children, with a median survival time of 179.75 months. The cumulative survival probabilities at 1 year, 2 years, 5 years, and 10 years after the diagnosis, were 99.13, 97.95, 90.11 and 78.63, respectively. Results from the multivariate Cox proportional hazard regression analysis showed that children who did not receive antiviral therapy were 12.81 times more likely to die than the ones who received the antiretroviral therapy (95: 11.40-14.27). Male HIV-infected children were 1.20 (95: 1.10-1.32) times more likely to die than the female HIV-infected children. The risk of death among HIV positive children at the age of 3 to 5 years was 0.67 (95: 0.60-0.76) times of those children who were diagnosed at the age of 2 years old or younger. The risk of death among children infected with HIV in Northwest was 0.52 (95: 0.29-0.95) times higher than the ones from the Northeast areas of China. The risk of death among children who received antiviral treatment (ART) in the residential areas was 1.96 (95: 1.48-2.61) times than those children who did not. The risk of death from children who did not receive health care services was 2.07 times of those children who did (95: 1.88-2.29). The median survival time of HIV-infected children aged ≤14 years old was 179.75 months, in China. Our findings revealed that initiation of antiviral therapy, female, age, place of receiving ART (out of the residential areas), living in Northwest China, care services and being diagnosed at older age . were protective factors influencing the survival time of infected children.
为了解中国14岁及以下HIV感染儿童的生存状况及相关影响因素，从中国艾滋病综合防治信息管理系统（CRIMS）中选取HIV感染儿童，进行回顾性队列研究以调查感染儿童的生存情况，采用Cox比例风险回归模型筛选影响生存时间的因素。本研究纳入8029例感染儿童，中位生存时间为179.75个月。诊断后1年、2年、5年和10年的累积生存概率分别为99.13%、97.95%、90.11%和78.63%。多因素Cox比例风险回归分析结果显示，未接受抗病毒治疗的儿童死亡风险是接受抗逆转录病毒治疗儿童的12.81倍（95%CI：11.40 - 14.27）。男性HIV感染儿童的死亡风险是女性HIV感染儿童的1.20倍（95%CI：1.10 - 1.32）。3至5岁HIV阳性儿童的死亡风险是2岁及以下诊断儿童的0.67倍（95%CI：0.60 - 0.76）。中国西北地区HIV感染儿童的死亡风险比东北地区高0.52倍（95%CI：0.29 - 0.95）。居住地区接受抗病毒治疗（ART）的儿童死亡风险是未接受治疗儿童的1.96倍（95%CI：1.48 - 2.61）。未接受医疗服务儿童的死亡风险是接受医疗服务儿童的2.07倍（95%CI：1.88 - 2.29）。中国14岁及以下HIV感染儿童的中位生存时间为179.75个月。我们的研究结果表明，开始抗病毒治疗、女性、年龄、接受抗病毒治疗的地点（非居住地区）、居住在中国西北地区、获得医疗服务以及诊断时年龄较大是影响感染儿童生存时间的保护因素。
